For skin, patch indicates any size skin lesion without significant elevation or induration. Presence/absence of hypopigmentation or hyperpigmentation, scale, crusting, and/or poikiloderma should be noted.

For skin, plaque indicates any size skin lesion that is elevated or indurated. Presence or absence of scale, crusting, and/or poikiloderma should be noted. Histologic features, such as folliculotropism or large-cell transformation (> 25% large cells), CD30⁺ or CD30⁻, and clinical features, such as ulceration, are important to document.

For skin, tumor indicates at least one 1-cm diameter solid or nodular lesion with evidence of depth and/or vertical growth. Note total number of lesions, total volume of lesions, largest size lesion, and region of body involved. Also note if histologic evidence of large-cell transformation has occurred. Phenotyping for CD30 is encouraged.

For node, abnormal peripheral lymph node(s) indicates any palpable peripheral node that on physical examination is firm, irregular, clustered, fixed, or 1.5 cm or larger in diameter. Node groups examined on physical examination include cervical, supraclavicular, epitrochlear, axillary, and inguinal. Central nodes, which are not generally amenable to pathologic assessment, are not currently considered in the nodal classification unless used to establish N3 histopathologically.

A T-cell clone is defined by polymerase chain reaction or Southern blot analysis of the T-cell receptor gene.

For viscera, spleen and liver may be diagnosed by imaging criteria.

For blood, SCs are defined as lymphocytes with hyperconvoluted cerebriform nuclei. If SCs are not able to be used to determine tumor burden for B2, then one of the following modified ISCL criteria along with a positive clonal rearrangement of the TCR may be used instead: (1) expanded CD4⁺ or CD3⁺ cells with CD4/CD8 ratio of 10 or more; or (2) expanded CD4⁺ cells with abnormal immunophenotype including loss of CD7 or CD26.